Friday, June 7, 2013

In
March 2010, President Obama signed into law a comprehensive health reform bill,
the Patient Protection and Affordable Care Act (ACA; P.L. 111-148), and a
package of amendments to ACA, the Health Care and Education Reconciliation
Act of 2010 (HCERA; P.L. 111-152). Health reform was one of President
Obama’s top domestic policy priorities during his first term, driven by
concerns about the growing ranks of the uninsured and the unsustainable growth
in spending on health care and health insurance. Improving access to care
and controlling rising costs were seen to require changes to both the
financing and delivery of health care. This report—one of a series of CRS
products on ACA, as amended—focuses on the law’s workforce, public health, health
care quality, and related provisions. It includes summaries of these
provisions, explores some of their implications for health policy, and
contains an associated timeline.

This report is primarily for reference purposes. The material in it is intended
to provide context to help the reader better understand the intent of ACA’s
individual provisions at the time of enactment. The report does not track
or discuss ongoing ACA-related regulatory and other implementation activities.

ACA includes numerous provisions intended to increase the primary care and
public health workforce, promote preventive services, and strengthen
quality measurement, among other things. It amends and expands many of the
existing health workforce programs authorized under Title VII (health
professions) and Title VIII (nursing) of the Public Health Service Act (PHSA); creates
a Public Health Services Track to train health care professionals emphasizing
team-based service, public health, epidemiology, and emergency
preparedness and response; and makes a number of changes to the Medicare
graduate medical education (GME) payments to teaching hospitals, in part
to encourage the training of more primary care physicians. The new law also establishes
a national commission to study projected health workforce needs.

In addition, ACA creates an interagency council to promote healthy policies and
prepare a national prevention and health promotion strategy. It
establishes a Prevention and Public Health Fund to boost funding for
prevention and public health; increases access to clinical preventive services
under Medicare and Medicaid; promotes healthier communities; and funds research
on optimizing the delivery of public health services. Funding also is
provided for maternal and child health services, including abstinence
education and a new home visitation program. ACA also establishes a
national strategy for quality improvement; creates an interagency working group
to advance quality efforts at the national level; develops a comprehensive
repertoire of quality measures; and formalizes processes for quality
measure selection, endorsement, data collection, and public reporting of
quality information. It creates and funds a new private, nonprofit comparative
effectiveness research institute.

Other key provisions in ACA include new requirements for the collection and
reporting of health data by race, ethnicity, and primary language to
detect and monitor trends in health disparities; and electronic format and
data standards to improve the efficiency of administrative and financial transactions
between health care providers and health plans; programs to prevent elder
abuse, neglect, and exploitation; a new regulatory pathway for licensing
biological drugs shown to be biosimilar or interchangeable with a licensed
biologic; new nutrition labeling requirements for chain restaurant menus
and vending machines.

Date of Report: May 17, 2013
Number of Pages: 137Order Number: R41278Price: $29.95

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